Appropriate Use of Dopamine Agonists and Levodopa in Restless Legs Syndrome in an Ambulatory Care Setting

Ogochukwu Chidozie Molokwu, PharmD


The Annals of Pharmacotherapy. 2008;42(5):627-632. 

In This Article


During the study period, 58 patients received either levodopa or ropinirole. Of these patients, 27 were included in the study for data collection and analysis ( Table 1 ). Thirty-one patients were excluded for the following reasons: no medical records available for review (n = 10), diagnosis of Parkinson's disease (n = 20), and 1 patient with HIV who received levodopa for an unknown indication.

There was documentation of RLS severity in 2 (7%) patients included in the study. These patients' symptoms were described as occurring nightly and the patients were reported as having problems sleeping at night as a result of the RLS symptoms. There was no documentation of RLS severity in the remaining 25 patients.

Patients' medical records were reviewed for availability of ferritin and transferrin-iron saturation (Tsat) percentage values. Ferritin and Tsat percentage were not obtained in 18 and 20 patients, respectively. Two patients had ferritin levels less than 50 ng/mL, while 7 patients had ferritin levels greater than 50 ng/mL. Tsat percentages less than 20% and greater than 20% were seen in 5 and 2 patients, respectively.

The use of antidepressants, mainly selective serotoninreuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), was identified in 14 patients. Six patients were taking sedating antihistamines and one was on an antidopaminergic drug.

There was no documentation of augmentation or rebound in any of the study patients, but levodopa was discontinued in one patient who developed left-sided facial twitching. There was no documentation of whether facial twitching resolved with discontinuation of levodopa.


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